Patients and their families should be clear: lacrimal system disease is a complex disease, the pathogenesis of which is unknown and cannot be 100% cured under current medical conditions! This is especially true for age-related, recurrent, and functional conditions! The lacrimal endoscope is currently the only aid that can perform lacrimal recanalization surgery under direct vision! This reduces the blindness of conventional surgical operations and the limitations of treatment, and avoids the current situation of pathological cure caused by surgical pseudo-duct formation. It is currently the leading international treatment for lacrimal obstructive diseases. Advantages of surgery: no facial skin incision, no effect on appearance, minimally invasive approach from the lacrimal dots; Indications for surgery: atresia or stenosis of the upper and lower lacrimal dots, obstruction or stenosis of the upper and lower lacrimal ducts, obstruction or stenosis of the common lacrimal duct, small lacrimal sac, no large amount of purulent secretions in the lacrimal sac (especially clear mucus gel-like secretions), obstruction or stenosis of the nasolacrimal duct, mucinous swelling of the lacrimal sac. Relative contraindications: high brow arch, old traumatic lacrimal duct rupture, trauma combined with nasolacrimal duct fracture dacryocystitis, large lacrimal sac, failure after transdermal facial lacrimal sac nasal anastomosis, recurrent episodes of acute lacrimal sac inflammation, ulcerated skin or incision and drainage of pus in the lacrimal sac area, previous surgery for nasal polyps or sinusitis, congenital nasolacrimal duct dysplasia causing lacrimal sac inflammation, foreign bodies, stones and benign lesions of hyperplasia in part of the lacrimal sac! The cost is about 5000 RMB/eye. However, because the current lacrimal endoscope is a rigid straight tube, the imaging resolution is not high, so it has some limitations for some cases. Preoperative examination: preoperative lacrimal sac imaging is required to determine the size and location of the lacrimal sac. Nasal endoscopy + photographs are performed. Orbital CT (coronal scan + plain scan) is also required in some patients. Pre-operative preparation: Pre-operative examination should be completed on an outpatient basis to exclude systemic diseases such as hypertension, heart disease, diabetes and other abnormalities in intraocular pressure, and nasal hair should be clipped to avoid contaminating the lens and affecting the visual field by contacting the intranasal lens during surgery. Preoperatively, the lower nasal passage was filled with 1/100,000 epinephrine solution and Elkayin solution for 1 time/20 minutes for 3 times. After surgery (after outpatients pay the fee and take the outpatient medical record) go to the second area for observation for 1-2 hours before going home (some patients need to remove the nasal hemostatic sponge). There is a possibility of blood in the nose for 1-2 months after surgery, and regular review is required. Tear duct irrigation: performed 3 days after surgery, through the need to flush the tear duct irrigation needle in the direction of the lower nasal tract. Postoperative review 1 week, 2 weeks, 1 month, 2 months, 3 months, ask the follow-up physician for details. Some patients may not be able to flush the lacrimal tract due to local tissue edema in the early stage, patients should not worry! Cold compresses can be applied to the operated eye! After the surgery, you can sneeze to expose the tube in the nostril, and then gently pull out the exposed tube in the front nostril by yourself in front of the mirror, and then use a cotton swab or small finger to plug it back into the nostril after cleaning. If the tube is not exposed, there is no need to do so! If you need to remove the tube, it should be done after the anastomosis is completely epithelialized (more than 2-6 months). Unless there is rejection of the prosthetic tube, infection, tearing of the lacrimal punctum, increased secretion, or if the prosthetic tube comes out and cannot be reset on its own. Postoperative medication: nasal spray medication: nortone (plus 1ml of compound neomycin ophthalmic solution mixture) nasal spray should be made back to the aspiration action. Tear irrigation medication: cotrimoxazole ophthalmic solution and chymotrypsin ophthalmic solution; eye drops medication: colistin ophthalmic solution (cotropic ophthalmic solution) and chymotrypsin ophthalmic solution, 4 times/day. You need to bring all medications for each review! (Use for more than 4-6 weeks). The success rate of surgery: Because lacrimal sac disease is not only a disease of the eye, but also closely related to nasal sinus disease and affects the efficacy, it cannot be cured in all cases, and the success rate of the first surgery is about 70-90% as reported internationally. Some patients with long tear duct obstruction due to bony obstruction cannot be opened with laser! Other surgical methods may be required. Postoperative complications: postoperative lacrimation, recurrence of obstruction, and even recurrent flow of pus may occur.